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Individual

ELLEN N. MEDRANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
180 CHURCH HILL RD STE 1, LEEDS, ME 04263-3418
(207) 524-3501
(207) 524-2093
Mailing address
180 CHURCH HILL RD STE 1, LEEDS, ME 04263-3418
(207) 524-3501
(207) 524-2093

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA428
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1083738736
ME
Enumeration date
03/19/2007
Last updated
06/25/2021
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